Original articleAdult cardiacHigh-Dose Tranexamic Acid Is an Independent Predictor of Early Seizure After Cardiopulmonary Bypass
Section snippets
Patients and Methods
The study protocol was in accordance with our local Institutional Research Ethics Board and received full approval.
Incidence of Early Seizure
Between 2004 and 2009, 8,929 patients underwent CPB through a midline sternotomy for CABG, replacement of the thoracic aorta, or a procedure involving entry into a left-sided cardiac chamber at the Quebec Heart and Lung Institute. Isolated CABG was performed in 5,510 patients (61.7%). Perioperative tranexamic acid was used in 8,082 patients (90.5%). Low-dose tranexamic acid (total dose < 100 mg/kg; range, 25 to 99.9; mean 59 ± 17.6) was used in 6,328 patients, and high-dose tranexamic acid
Comment
This study documented early seizure in 119 of 8,929 patients (1.3%) undergoing CPB, nearly 90% of whom were undergoing operations involving left-sided cardiac chamber entry or aortic operations, or both, with the remaining 10% occurring in isolated CABG patients. Early seizure was associated with renal failure, prolonged intubation, and increased hospital resource utilization, effects that persisted after multivariate risk-adjustment using propensity scores. In addition to advanced age,
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